초록접수 현황
| 19F-120 | 구연 발표 |
Fate of Dilated Ascending Aorta after Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Disease
Min-Seok Kim, Jung Whan Kim, Seung Hyun Lee, Sak Lee, Young-Nam Youn, Kyung-Jong Yoo, Hyun-Chel Choo
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : The aims of the study were (1)to compare the long-term outcomes and assess the difference in dilatation rates of ascending aorta after aortic valve replacement(AVR) between patients with bicuspid(BAV) or tricuspid aortic valve(TAV) and (2)to evaluate risk factors associated with ascending aorta dilatation and aortic events.
Methods : 259patients(median age,62.3[54.6, 69.8]years;105 BAV,154 TAV) with a dilated ascending aorta(diameter≥40mm) but did not underwent concomitant ascending aorta surgery at the time of AVR were included. A propensity score-matched analysis was used to match the BAV group(n=98) with the TAV group(n=98). Long-term outcomes and freedom from aortic events were analyzed. Risk factors for ascending aorta dilatation, mortality, and aortic events after AVR were identified.
Results : Follow-up was complete in 100% of patients with a median follow-up duration of 106.1[68.8, 163.0] months. Early clinical outcomes and differences in dilatation rate of ascending aorta diameter were similar between the 2 groups. Overall survivals at 5,10, and 15years were 97.1%,91.7%,and 81.4% in BAV group, respectively, and 95.4%,86.5%,and 74.2% in TAV group, respectively(P=0.223). Aortic events were occurred in 6 patients(2 in BAV group, 4 in TAV group;P=0.678). Preoperative ascending aorta diameter was the only variable analyzed to be related to the aortic expansion and aortic events during the follow-up(P<0.001 and P<0.001, respectively).
Conclusion : Long-term outcomes and expansion rate in ascending aorta were similar after AVR in BAV and TAV patients upto 15 years postoperatively. BAV was not revealed to be a risk factor of mortality or aortic event. Aggressive treatment in BAV patients with ascending aorta dilatation is not suggested.
Methods : 259patients(median age,62.3[54.6, 69.8]years;105 BAV,154 TAV) with a dilated ascending aorta(diameter≥40mm) but did not underwent concomitant ascending aorta surgery at the time of AVR were included. A propensity score-matched analysis was used to match the BAV group(n=98) with the TAV group(n=98). Long-term outcomes and freedom from aortic events were analyzed. Risk factors for ascending aorta dilatation, mortality, and aortic events after AVR were identified.
Results : Follow-up was complete in 100% of patients with a median follow-up duration of 106.1[68.8, 163.0] months. Early clinical outcomes and differences in dilatation rate of ascending aorta diameter were similar between the 2 groups. Overall survivals at 5,10, and 15years were 97.1%,91.7%,and 81.4% in BAV group, respectively, and 95.4%,86.5%,and 74.2% in TAV group, respectively(P=0.223). Aortic events were occurred in 6 patients(2 in BAV group, 4 in TAV group;P=0.678). Preoperative ascending aorta diameter was the only variable analyzed to be related to the aortic expansion and aortic events during the follow-up(P<0.001 and P<0.001, respectively).
Conclusion : Long-term outcomes and expansion rate in ascending aorta were similar after AVR in BAV and TAV patients upto 15 years postoperatively. BAV was not revealed to be a risk factor of mortality or aortic event. Aggressive treatment in BAV patients with ascending aorta dilatation is not suggested.
책임저자: Hyun-Chel Choo
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Min-Seok Kim, E-mail : mesmerist84@gmail.com